MedMe Pharmacy Patient - Definitions - MedMe Pharmacy Services Implementation Guide v0.9.24

idstring

Is Modifier false

Summary true

4. Patient.meta

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Short Metadata including profile versionMetadata about the resource

Control 10..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. Patient.meta.source

Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Short URI identifying the source system of the resourceIdentifies where the resource comes from

Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

8. Patient.implicitRules

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short A set of rules under which this content was created

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

10. Patient.extension

Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Short ExtensionAdditional content defined by implementations

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control 10..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

12. Patient.extension:indigenousIdentity

Slice Name indigenousIdentity

Definition

A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.

Short Extension for representing a code classifying a person's indigenous identity.

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Indigenous Identity) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

14. Patient.extension:racializedGroup

Slice Name racializedGroup

Definition

A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.

Short Extension for representing a code classifying a person's racialized group.

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Racialized Group) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

16. Patient.extension:recordedSexOrGender

Slice Name recordedSexOrGender

Definition

Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction.

Short Recorded sex or gender (RSG) information includes the various sex and gender concepts.

Comments

Control 0..*

Type Extension(Person Recorded Sex Or Gender) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

18. Patient.extension:recordedSexOrGender.extension

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Short Additional content defined by implementations

Comments

Control 10..*

Is Modifier false

Summary false

Alternate Names extensions, user content

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

This element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

20. Patient.extension:recordedSexOrGender.extension:value

Slice Name value

Definition

A sex or gender property for the individual from a document or other record

Short The recorded sex or gender property for the individualAdditional content defined by implementations

Control 10..1*

Is Modifier false

Summary false

22. Patient.extension:recordedSexOrGender.extension:value.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

24. Patient.extension:recordedSexOrGender.extension:value.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value value

26. Patient.extension:recordedSexOrGender.extension:value.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Binding Unless not suitable, these codes SHALL be taken from For codes, see Recorded Gender Value Set
(extensible to https://fhir.infoway-inforoute.ca/ValueSet/recordedgender)

Type CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

28. Patient.extension:recordedSexOrGender.extension:type

Slice Name type

Definition

The type or category of sex or gender that is recorded.

Short Type of recorded sex or gender.Additional content defined by implementations

Comments

Because the recorded sex or gender concept exists primarily as means to exchange sex and gender data concepts that are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, the type is used to identify what type of concept the recorded sex or gender concept is.

Control 0..1*

Is Modifier false

Summary false

30. Patient.extension:recordedSexOrGender.extension:type.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

32. Patient.extension:recordedSexOrGender.extension:type.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value type

34. Patient.extension:recordedSexOrGender.extension:type.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Binding The codes SHALL be taken from For codes, see Recorded Gender Type Value Set
(required to https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Pattern Value { "coding" : [{ "system" : "http://loinc.org", "code" : "99502-7", "display" : "Recorded sex or gender" }] }

36. Patient.extension:recordedSexOrGender.extension:effectivePeriod

Slice Name effectivePeriod

Definition

The time period during which the recorded sex or gender value applies to the individual

Short When the recorded sex or gender value appliesAdditional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

38. Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

40. Patient.extension:recordedSexOrGender.extension:effectivePeriod.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value effectivePeriod

42. Patient.extension:recordedSexOrGender.extension:acquisitionDate

Slice Name acquisitionDate

Definition

The date/time when the sex or gender value was first recorded in the system.

Short When the sex or gender value was recorded.Additional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

44. Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

46. Patient.extension:recordedSexOrGender.extension:acquisitionDate.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value acquisitionDate

48. Patient.extension:recordedSexOrGender.extension:acquisitionDate.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Type dateTime, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

50. Patient.extension:recordedSexOrGender.extension:sourceDocument

Slice Name sourceDocument

Definition

The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded.

Short The document the sex or gender property was acquired from.Additional content defined by implementations

Comments

For example, if a driver's license is scanned, this property may reference that scanned document.

Control 0..1*

Is Modifier false

Summary false

52. Patient.extension:recordedSexOrGender.extension:sourceDocument.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

54. Patient.extension:recordedSexOrGender.extension:sourceDocument.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value sourceDocument

56. Patient.extension:recordedSexOrGender.extension:sourceDocument.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Type Choice of: CodeableConcept, Reference(DocumentReference), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

58. Patient.extension:recordedSexOrGender.extension:sourceField

Slice Name sourceField

Definition

The name of the field within the source document where this sex or gender property is initially recorded.

Short The name of the field within the source document where this sex or gender property is initially recorded.Additional content defined by implementations

Comments

For example, if a sex value is acquired from a driver's license, and the name of the field on that driver's license is 'SEX', then a code describing that field can be provided. If the semantics of the field are known, they may be described in the comment. For example, if the 'SEX' field on a license in a particular state or province is populated based on an individual's indication of what gender they consider themselves to be, but the field label is 'SEX' for historical reasons, a comment describing that the semantics of the field align with gender identity, even though the field name is 'SEX' can be provided.

Control 0..1*

Is Modifier false

Summary false

60. Patient.extension:recordedSexOrGender.extension:sourceField.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

62. Patient.extension:recordedSexOrGender.extension:sourceField.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value sourceField

64. Patient.extension:recordedSexOrGender.extension:sourceField.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Type string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

66. Patient.extension:recordedSexOrGender.extension:jurisdiction

Slice Name jurisdiction

Definition

The jurisdiction or organization that issued the document from which the sex or gender was aquired

Short Who issued the document where the sex or gender was aquiredAdditional content defined by implementations

Comments

For example, a individual's driver's license or passport would be issued by a specific state or country.

Control 0..1*

Is Modifier false

Summary false

68. Patient.extension:recordedSexOrGender.extension:jurisdiction.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

70. Patient.extension:recordedSexOrGender.extension:jurisdiction.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value jurisdiction

72. Patient.extension:recordedSexOrGender.extension:jurisdiction.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Binding Unless not suitable, these codes SHALL be taken from For codes, see Jurisdiction ValueSet
(extensible to http://terminology.hl7.org/ValueSet/jurisdiction)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

74. Patient.extension:recordedSexOrGender.extension:comment

Slice Name comment

Definition

Further explanation about the context or source of the recorded sex or gender value

Short Context or source information about the recorded sex or genderAdditional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

76. Patient.extension:recordedSexOrGender.extension:comment.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

78. Patient.extension:recordedSexOrGender.extension:comment.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value comment

80. Patient.extension:recordedSexOrGender.extension:comment.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

82. Patient.extension:recordedSexOrGender.extension:genderElementQualifier

Slice Name genderElementQualifier

Definition

Instances of the individual-recordedSexOrGender extension with this value set to 'true' provides additional semantics or provenance of the data communicated in the relevant '.gender' property in the resource. For example, if a system populates Patient.gender using a sex assigned at birth value, the individual-recordedSexOrGender extension with genderElementQualifier=true can provide that context.

Short Whether this recorded sex or gender value qualifies the .gender element.Additional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

84. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

86. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value genderElementQualifier

88. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Type boolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

90. Patient.extension:recordedSexOrGender.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender

92. Patient.extension:recordedSexOrGender.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..01
This element is affected by the following invariants: ext-1

Type Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, integer64, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, CodeableReference, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, RatioRange, Reference, SampledData, Signature, Timing, ContactDetail, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Availability, ExtendedContactDetail, Dosage, Meta, Contributor

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

94. Patient.extension:genderIdentity

Slice Name genderIdentity

Definition

A code that specifies an individual's personal experience of being a woman, man, nonbinary, or how the person prefers to self-describe. People may identify with more than one gender identity or use different gender identities in different settings.

Short Extension for representing how the person prefers to self-describe.

Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Control 0..*

Type Extension(Individual Gender Identity) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

96. Patient.extension:genderIdentity.extension

Definition

Short Additional content defined by implementations

Comments

Control 10..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

98. Patient.extension:genderIdentity.extension:value

Slice Name value

Definition

An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

Short The individual's gender identityAdditional content defined by implementations

Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Control 10..1*

Is Modifier false

Summary false

100. Patient.extension:genderIdentity.extension:value.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

102. Patient.extension:genderIdentity.extension:value.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value value

104. Patient.extension:genderIdentity.extension:value.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Binding Unless not suitable, these codes SHALL be taken from For codes, see Gender Identity Value Set
(extensible to https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

106. Patient.extension:genderIdentity.extension:period

Slice Name period

Definition

The time period during which the gender identity applies to the individual

Short The time period during which the gender identity applies to the individualAdditional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

108. Patient.extension:genderIdentity.extension:period.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

110. Patient.extension:genderIdentity.extension:period.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value period

112. Patient.extension:genderIdentity.extension:period.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

Type Period, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

114. Patient.extension:genderIdentity.extension:comment

Slice Name comment

Definition

Text to further explain the use of the specified gender identity

Short Text to further explain the use of the specified gender identityAdditional content defined by implementations

Control 0..1*

Is Modifier false

Summary false

116. Patient.extension:genderIdentity.extension:comment.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..0*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

118. Patient.extension:genderIdentity.extension:comment.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value comment

120. Patient.extension:genderIdentity.extension:comment.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 10..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

122. Patient.extension:genderIdentity.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/individual-genderIdentity

124. Patient.extension:genderIdentity.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..01
This element is affected by the following invariants: ext-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

126. Patient.extension:pronouns

Slice Name pronouns

Definition

A linguistic tool used to refer to people instead of using their name, a noun, or a noun phrase. Gender pronouns are third-person pronouns that may reference a person's gender identity (e.g. he, she, they) and that may be a part of their gender expression.

Short Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)

Comments

This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release

Control 0..*

Type Extension(Individual Pronouns) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

128. Patient.extension:birthsex

Slice Name birthsex

Definition

A code that specifies the sex of a person at birth which is a clinical finding, usually determined by a clinician based on phenotypic (e.g. genitals or gonads), physiologic (e.g. hormone levels) and/or genetic characteristics.

Short A code that specifies the sex of a person at birth which is a clinical finding

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Extension: Birth Sex) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

130. Patient.extension:CommunicationBarrier

Slice Name CommunicationBarrier

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Communication Barrier) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

132. Patient.extension:locationId

Slice Name locationId

Definition

Reference to the location where the patient is registered or primarily receives care.

Short Reference to the location where the patient is registered

Control 1..1

Type Extension(Location ID) (Extension Type: string)

Is Modifier false

Summary false

134. Patient.modifierExtension

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Names extensions, user content

136. Patient.identifier

Definition

An identifier for this patient.

Short Patient identifiers including MedMe ID and optional JHN, PCIDAn identifier for this patient

Note This is a business identifier, not a resource identifier (see discussion)

Control 10..*

Is Modifier false

Must Support true

Summary true

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
medme-pcid-system-check: If PCID system is present, type code must be PT (where(system = 'https://fhir.medmehealth.com/pharmacy-services/systems/entity/patient/pc-id').all(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='PT').exists()))
medme-pcid-count: Maximum one PCID identifier allowed (where(system = 'https://fhir.medmehealth.com/pharmacy-services/systems/entity/patient/pc-id').count() <= 1)

This element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:

pattern @ type

138. Patient.identifier:JHN

Slice Name JHN

Definition

Patient and person health numbers used by all jurisdictions across Canada

An identifier for this patient.

Short Jurisdictional Health NumberAn identifier for this patient

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

140. Patient.identifier:JHN.extension:versionCode

Slice Name versionCode

Definition

Optional Extension Element - found in all resources.

Short Health Number Version Code

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Extension: Identifier Version) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

142. Patient.identifier:JHN.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

144. Patient.identifier:JHN.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control 10..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Must Support true

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "JHN", "display" : "Jurisdictional Health Number" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

146. Patient.identifier:JHN.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short A Health Number Naming System from the Canadian URI RegistryThe namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

148. Patient.identifier:JHN.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

150. Patient.identifier:MRN

Slice Name MRN

Definition

A local patient identifier from the submitting PoS System

An identifier for this patient.

Short Medical Record NumberAn identifier for this patient

Comments

Some jurisdictions may consider the MRN identifier type to be an alternative to the JHN identifier type under certain scenarios. These business rules are outside the scope of this profile, however the slice is socialized to prepare implementers for potential use of this pattern within certain jurisdictions

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. Patient.identifier:MRN.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

154. Patient.identifier:MRN.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 10..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Must Support true

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR", "display" : "Medical Record Number" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

156. Patient.identifier:MRN.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short An identifier for the system supplying the MRNThe namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

158. Patient.identifier:MRN.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

160. Patient.identifier:patientId

Slice Name patientId

Definition

An identifier for this patient.

Short MedMe patient identifierAn identifier for this patient

Note This is a business identifier, not a resource identifier (see discussion)

Control 10..1*

Is Modifier false

Must Support true

Summary true

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
medme-identifier-required: At least one MedMe identifier is required (system.matches('https://fhir\.medmehealth\.com/pharmacy-services/systems/entity/(organization/[^/]+/)?patient/id'))

162. Patient.identifier:patientId.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

164. Patient.identifier:patientId.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

166. Patient.identifier:jhn

Slice Name jhn

Definition

An identifier for this patient.

Short Optional identifier representing Patient JHN (Quebec)An identifier for this patient

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1*

Is Modifier false

Must Support true

Summary true

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
jhn-extension-format: Must provide JHN version code if extension is used (extension.where(url = 'http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion').all(valueString.exists() and valueString.length() > 0))

168. Patient.identifier:jhn.extension

Definition

An Extension

Short ExtensionAdditional content defined by implementations

Comments

Control 0..1*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

170. Patient.identifier:jhn.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

172. Patient.identifier:jhn.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "JHN" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

174. Patient.active

Definition

Whether this patient record is in active use. Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules.

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Short Whether the patient is activeWhether this patient's record is in active use

Comments

it is strongly recommended to populate the active element, as it is a modifier element which changes the context of the resource. It is very valuable to include, especially for its search capabilities, e.g. searching for only active patients

If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.

Control 10..1

Is Modifier true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Meaning if Missing This resource is generally assumed to be active if no value is provided for the active element

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

176. Patient.name

Definition

A name associated with the individual.

Short Patient's nameA name associated with the patient

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Control 10..*

HumanName

Is Modifier false

Must Support true

Summary true

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

Need to be able to track the patient by multiple names. Examples are your official name and a partner name.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ca-core-pat-1: Either Patient.name.given and/or Patient.name.family SHALL be present. ((family.exists() or given.exists()))

178. Patient.name.use

Definition

Identifies the purpose for this name.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

The use of a human name.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

180. Patient.name.family

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Short Family nameFamily name (often called 'Surname')

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names surname

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

182. Patient.name.given

Definition

Given name.

Short Given namesGiven names (not always 'first'). Includes middle names

Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

Control 10..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names first name, middle name

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

184. Patient.name.period

Definition

Indicates the period of time when this name was valid for the named person.

Short Time period when name was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows names to be placed in historical context.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

186. Patient.name.period.end

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Short End time with inclusive boundary, if not ongoing

Comments

This attribute is considered 'Recommended - Allow Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Control 0..1
This element is affected by the following invariants: per-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Meaning if Missing If the end of the period is missing, it means that the period is ongoing

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

188. Patient.telecom

Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

Short A contact detail for the individual

Comments

A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).

Control 0..*

ContactPoint

Is Modifier false

Must Support true

Summary true

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

190. Patient.telecom.system

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Short phone | fax | email | pager | url | sms | other

Control 10..1
This element is affected by the following invariants: cpt-2

Binding The codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
(required to http://hl7.org/fhir/ValueSet/contact-point-system)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

192. Patient.telecom.value

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Short The actual contact point details

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

194. Patient.telecom.use

Definition

Identifies the purpose for the contact point.

Short home | work | temp | old | mobile - purpose of this contact point

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

Binding The codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/contact-point-use)

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

196. Patient.telecom.period

Definition

Time period when the contact point was/is in use.

Short Time period when the contact point was/is in use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. Patient.telecom.period.end

Definition

Short End time with inclusive boundary, if not ongoing

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Control 0..1
This element is affected by the following invariants: per-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Meaning if Missing If the end of the period is missing, it means that the period is ongoing

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

200. Patient.gender

Definition

The documented sex or gender of an individual used for clinical, official, or legal purposes where only one data field for sex and gender is available, and where it is the value found in the local system and/or historical documentation.

Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.

Short Administrative gendermale | female | other | unknown

Comments

The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex.

Control 10..1

Binding The codes SHALL be taken from AdministrativeGenderhttp://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
(required to http://hl7.org/fhir/ValueSet/administrative-gender)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

202. Patient.deceased[x]

Definition

Indicates if the individual is deceased or not.

Short Indicates if the individual is deceased or not

Comments

If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

Control 0..1

Type Choice of: boolean, dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

204. Patient.address

Definition

An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.

An address for the individual.

Short Addresses for the individualAn address for the individual

Comments

Note: address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).

Patient may have multiple addresses with different uses or applicable periods.

Control 0..*
This element is affected by the following invariants: ele-1

Type Address(Address(CA Core))

Is Modifier false

Must Support true

Summary true

Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

206. Patient.address.use

Definition

The purpose of this address.

Short home | work | temp | old | billing - purpose of this address

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

The use of an address.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows an appropriate address to be chosen from a list of many.

Example General: home

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

208. Patient.address.line

Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Short Street name, number, direction & P.O. Box etc.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General: 137 Nowhere Street

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

210. Patient.address.city

Definition

The name of the city, town, suburb, village or other community or delivery center.

Short Name of city, town etc.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names Municpality

Example General: Erewhon

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

212. Patient.address.state

Definition

The Province or Territory of Canada, or Province, Territory of State of another country. Recommend use of ISO 3166-2 Subdivision codes for provinces in Canada https://www.iso.org/obp/ui/#iso:code:3166:CA

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

Short Sub-unit of country (abbreviations ok)

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names Province, Territory

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

214. Patient.address.postalCode

Definition

A postal code designating a region defined by the postal service.

Short Postal code for area

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names Zip

Example General: 9132

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

216. Patient.address.country

Definition

Recommend use of the HL7 Country ValueSet 3 letter code https://terminology.hl7.org/ValueSet-v3-Country.html which include codes from urn:iso:std:iso:3166 https://www.iso.org/iso-3166-country-codes.html

Country - a nation as commonly understood or generally accepted.

Short Country (e.g. can be ISO 3166 2 or 3 letter code)

Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

218. Patient.communication

Definition

A language which may be used to communicate with the patient about his or her health.

Short Languages which may be used to communicate with the patientA language which may be used to communicate with the patient about his or her health

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

Control 0..*

Is Modifier false

Summary false

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

220. Patient.communication.modifierExtension

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

222. Patient.communication.language

Definition

The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-EN" for England English.

Short The language which can be used to communicate with the patient about his or her health

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Control 1..1

The codes SHOULD be taken from http://terminology.hl7.org/NamingSystem/iso639-3http://hl7.org/fhir/ValueSet/languages|4.0.1
(preferred to http://terminology.hl7.org/NamingSystem/iso639-3)

A human language.

Additional Bindings

Purpose

Is Modifier false

Summary false

Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

224. Patient.communication.language.coding

Definition

A reference to a code defined by a terminology system.

Short Code defined by a terminology system

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Control 10..1*

Is Modifier false

Summary true

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

226. Patient.communication.language.coding.system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Short Identity of the terminology system

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Fixed Value http://terminology.hl7.org/CodeSystem/language

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

228. Patient.communication.language.coding.code

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Short Symbol in syntax defined by the system

Control 10..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to refer to a particular code in the system.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

230. Patient.generalPractitioner

Definition

Patient's nominated care provider.

Short Patient's nominated primary care provider

Comments

This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues.

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

Control 0..*

Type Reference(Practitioner (CA-Core), PractitionerRole (CA-Core), Organization (CA-Core), Organization, Practitioner, PractitionerRole)

Is Modifier false

Must Support true

Must Support Types No must-support rules about the choice of types/profiles

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

232. Patient.managingOrganization

Definition

Organization that is the custodian of the patient record.

Short Organization that manages the care of this patientOrganization that is the custodian of the patient record

Comments

There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).

Control 10..1

Type Reference(MedMe Pharmacy Organization, Organization)

Is Modifier false

Summary true

Requirements

Need to know who recognizes this patient record, manages and updates it.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

234. Patient.link

Definition

Link to another patient resource that concerns the same actual patient.

Short Link to another patient resource that concerns the same actual person

Comments

There is no assumption that linked patient records have mutual links.

Control 0..*

Is Modifier true because This element is labeled as a modifier because it might not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'

Summary true

Requirements

There are multiple use cases:

Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
Distribution of patient information across multiple servers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

236. Patient.link.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

238. Patient.link.other

Definition

The other patient resource that the link refers to.

Short The other patient or related person resource that the link refers to

Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Control 1..1

Type Reference(Patient, RelatedPerson, Patient, RelatedPerson)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

240. Patient.link.type

Definition

The type of link between this patient resource and another patient resource.

Short replaced-by | replaces | refer | seealso

Control 1..1

The codes SHALL be taken from LinkTypehttp://hl7.org/fhir/ValueSet/link-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

The type of link between this patient resource and another patient resource.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Patient
2. Patient.id
Short	Unique identifier for the patient
4. Patient.meta
Short	Metadata including profile version
Control	1..?
6. Patient.meta.source
Short	URI identifying the source system of the resource
Control	1..?
8. Patient.extension
Control	1..?
10. Patient.extension:locationId
Slice Name	locationId
Short	Reference to the location where the patient is registered
Control	1..1
Type	Extension(Location ID) (Extension Type: string)
12. Patient.identifier
Short	Patient identifiers including MedMe ID and optional JHN, PCID
Note	This is a business identifier, not a resource identifier (see discussion)
Control	1..?
Invariants	medme-pcid-system-check: If PCID system is present, type code must be PT (`where(system = 'https://fhir.medmehealth.com/pharmacy-services/systems/entity/patient/pc-id').all(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='PT').exists())`) medme-pcid-count: Maximum one PCID identifier allowed (`where(system = 'https://fhir.medmehealth.com/pharmacy-services/systems/entity/patient/pc-id').count() <= 1`)
14. Patient.identifier:patientId
Slice Name	patientId
Short	MedMe patient identifier
Note	This is a business identifier, not a resource identifier (see discussion)
Control	1..1
Invariants	medme-identifier-required: At least one MedMe identifier is required (`system.matches('https://fhir\.medmehealth\.com/pharmacy-services/systems/entity/(organization/[^/]+/)?patient/id')`)
16. Patient.identifier:patientId.type
Pattern Value	`{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR" }] }`
18. Patient.identifier:jhn
Slice Name	jhn
Short	Optional identifier representing Patient JHN (Quebec)
Note	This is a business identifier, not a resource identifier (see discussion)
Control	0..1
Invariants	jhn-extension-format: Must provide JHN version code if extension is used (`extension.where(url = 'http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion').all(valueString.exists() and valueString.length() > 0)`)
20. Patient.identifier:jhn.extension
Control	0..1
22. Patient.identifier:jhn.type
Pattern Value	`{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "JHN" }] }`
24. Patient.active
Short	Whether the patient is active
Control	1..?
26. Patient.name
Short	Patient's name
28. Patient.name.family
Short	Family name
Control	1..?
30. Patient.name.given
Short	Given names
Control	1..?
32. Patient.telecom
34. Patient.telecom.system
Control	1..?
Binding	The codes SHALL be taken from ContactPointSystem (required to `http://hl7.org/fhir/ValueSet/contact-point-system`)
36. Patient.telecom.use
Binding	The codes SHALL be taken from ContactPointUse (required to `http://hl7.org/fhir/ValueSet/contact-point-use`)
38. Patient.gender
Short	Administrative gender
Control	1..?
Binding	The codes SHALL be taken from AdministrativeGender (required to `http://hl7.org/fhir/ValueSet/administrative-gender`)
40. Patient.address
Short	Addresses for the individual
42. Patient.address.state
Short	Sub-unit of country (abbreviations ok)
44. Patient.address.country
Short	Country (e.g. can be ISO 3166 2 or 3 letter code)
46. Patient.contact
48. Patient.contact.relationship
50. Patient.contact.relationship.coding
Control	1..1
52. Patient.contact.relationship.coding.system
Fixed Value	`http://hl7.org/fhir/ValueSet/patient-contactrelationship`
54. Patient.contact.relationship.coding.code
Control	1..?
56. Patient.contact.name
58. Patient.contact.name.family
Short	Family name
60. Patient.contact.name.given
Short	Given names
62. Patient.contact.telecom
Short	Contact details
64. Patient.contact.telecom.system
Control	1..?
Binding	The codes SHALL be taken from ContactPointSystem (required to `http://hl7.org/fhir/ValueSet/contact-point-system`)
66. Patient.contact.telecom.value
Control	1..?
68. Patient.communication
Short	Languages which may be used to communicate with the patient
70. Patient.communication.language
72. Patient.communication.language.coding
Control	1..1
74. Patient.communication.language.coding.system
Fixed Value	`http://terminology.hl7.org/CodeSystem/language`
76. Patient.communication.language.coding.code
Control	1..?
78. Patient.managingOrganization
Short	Organization that manages the care of this patient
Control	1..?
Type	Reference(MedMe Pharmacy Organization)

Guidance on how to interpret the contents of this table can be foundhere

0. Patient

Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Short Information about an individual or animal receiving health care services

Control 0..*

Is Modifier false

Summary false

Alternate Names SubjectOfCare Client Resident

Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())

2. Patient.id

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Short Unique identifier for the patient

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control 0..1

Is Modifier false

Summary true

4. Patient.meta

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Short Metadata including profile version

Control 1..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. Patient.meta.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

8. Patient.meta.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

10. Patient.meta.versionId

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Short Version specific identifier

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

12. Patient.meta.lastUpdated

Definition

When the resource last changed - e.g. when the version changed.

Short When the resource version last changed

Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control 0..1

instant

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

14. Patient.meta.source

Definition

Short URI identifying the source system of the resource

Comments

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

16. Patient.meta.profile

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Short Profiles this resource claims to conform to

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control 0..*

Type canonical(StructureDefinition)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

18. Patient.meta.security

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Short Security Labels applied to this resource

Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Control 0..*

Unless not suitable, these codes SHALL be taken from All Security Labels
(extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

Security Labels from the Healthcare Privacy and Security Classification System.

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

20. Patient.meta.tag

Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Short Tags applied to this resource

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Control 0..*

For example codes, see CommonTags
(example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

22. Patient.implicitRules

Definition

Short A set of rules under which this content was created

Comments

Control 0..1

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

24. Patient.language

Definition

The base language in which the resource is written.

Short Language of the resource content

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control 0..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

26. Patient.text

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Short Text summary of the resource, for human interpretation

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control 0..1

Narrative

Is Modifier false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

28. Patient.contained

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Short Contained, inline Resources

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control 0..*

Resource

Is Modifier false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

30. Patient.extension

Definition

An Extension

Short Extension

Control 1..*

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

32. Patient.extension:indigenousIdentity

Slice Name indigenousIdentity

Definition

A code classifying a person's self-identification as either First Nations, Inuk/Inuit and/or Métis.

Short Extension for representing a code classifying a person's indigenous identity.

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Indigenous Identity) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

34. Patient.extension:racializedGroup

Slice Name racializedGroup

Definition

A code that identifies a social construct most often characterized by phenotype or appearance (e.g. skin colour) in which the client identifies.

Short Extension for representing a code classifying a person's racialized group.

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Racialized Group) (Extension Type: CodeableConcept)

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

36. Patient.extension:recordedSexOrGender

Slice Name recordedSexOrGender

Definition

Short Recorded sex or gender (RSG) information includes the various sex and gender concepts.

Comments

Control 0..*

Type Extension(Person Recorded Sex Or Gender) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

38. Patient.extension:recordedSexOrGender.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

40. Patient.extension:recordedSexOrGender.extension

Definition

Short Additional content defined by implementations

Comments

Control 1..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

42. Patient.extension:recordedSexOrGender.extension:value

Slice Name value

Definition

A sex or gender property for the individual from a document or other record

Short The recorded sex or gender property for the individual

Control 1..1

Is Modifier false

Summary false

44. Patient.extension:recordedSexOrGender.extension:value.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

46. Patient.extension:recordedSexOrGender.extension:value.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

48. Patient.extension:recordedSexOrGender.extension:value.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value value

50. Patient.extension:recordedSexOrGender.extension:value.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

Binding Unless not suitable, these codes SHALL be taken from Recorded Gender Value Set
(extensible to https://fhir.infoway-inforoute.ca/ValueSet/recordedgender)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

52. Patient.extension:recordedSexOrGender.extension:type

Slice Name type

Definition

The type or category of sex or gender that is recorded.

Short Type of recorded sex or gender.

Comments

Control 0..1

Is Modifier false

Summary false

54. Patient.extension:recordedSexOrGender.extension:type.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

56. Patient.extension:recordedSexOrGender.extension:type.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

58. Patient.extension:recordedSexOrGender.extension:type.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value type

60. Patient.extension:recordedSexOrGender.extension:type.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

Binding The codes SHALL be taken from Recorded Gender Type Value Set
(required to https://fhir.infoway-inforoute.ca/ValueSet/recordedgendertype)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Pattern Value { "coding" : [{ "system" : "http://loinc.org", "code" : "99502-7", "display" : "Recorded sex or gender" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

62. Patient.extension:recordedSexOrGender.extension:effectivePeriod

Slice Name effectivePeriod

Definition

The time period during which the recorded sex or gender value applies to the individual

Short When the recorded sex or gender value applies

Control 0..1

Is Modifier false

Summary false

64. Patient.extension:recordedSexOrGender.extension:effectivePeriod.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

66. Patient.extension:recordedSexOrGender.extension:effectivePeriod.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

68. Patient.extension:recordedSexOrGender.extension:effectivePeriod.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value effectivePeriod

70. Patient.extension:recordedSexOrGender.extension:effectivePeriod.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

72. Patient.extension:recordedSexOrGender.extension:acquisitionDate

Slice Name acquisitionDate

Definition

The date/time when the sex or gender value was first recorded in the system.

Short When the sex or gender value was recorded.

Control 0..1

Is Modifier false

Summary false

74. Patient.extension:recordedSexOrGender.extension:acquisitionDate.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

76. Patient.extension:recordedSexOrGender.extension:acquisitionDate.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

78. Patient.extension:recordedSexOrGender.extension:acquisitionDate.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value acquisitionDate

80. Patient.extension:recordedSexOrGender.extension:acquisitionDate.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

82. Patient.extension:recordedSexOrGender.extension:sourceDocument

Slice Name sourceDocument

Definition

The reference to the source document or the code representing the type of document where this sex or gender property is initially recorded.

Short The document the sex or gender property was acquired from.

Comments

For example, if a driver's license is scanned, this property may reference that scanned document.

Control 0..1

Is Modifier false

Summary false

84. Patient.extension:recordedSexOrGender.extension:sourceDocument.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

86. Patient.extension:recordedSexOrGender.extension:sourceDocument.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

88. Patient.extension:recordedSexOrGender.extension:sourceDocument.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value sourceDocument

90. Patient.extension:recordedSexOrGender.extension:sourceDocument.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

Type Choice of: CodeableConcept, Reference(DocumentReference)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

92. Patient.extension:recordedSexOrGender.extension:sourceField

Slice Name sourceField

Definition

The name of the field within the source document where this sex or gender property is initially recorded.

Short The name of the field within the source document where this sex or gender property is initially recorded.

Comments

Control 0..1

Is Modifier false

Summary false

94. Patient.extension:recordedSexOrGender.extension:sourceField.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

96. Patient.extension:recordedSexOrGender.extension:sourceField.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

98. Patient.extension:recordedSexOrGender.extension:sourceField.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value sourceField

100. Patient.extension:recordedSexOrGender.extension:sourceField.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. Patient.extension:recordedSexOrGender.extension:jurisdiction

Slice Name jurisdiction

Definition

The jurisdiction or organization that issued the document from which the sex or gender was aquired

Short Who issued the document where the sex or gender was aquired

Comments

For example, a individual's driver's license or passport would be issued by a specific state or country.

Control 0..1

Is Modifier false

Summary false

104. Patient.extension:recordedSexOrGender.extension:jurisdiction.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

106. Patient.extension:recordedSexOrGender.extension:jurisdiction.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

108. Patient.extension:recordedSexOrGender.extension:jurisdiction.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value jurisdiction

110. Patient.extension:recordedSexOrGender.extension:jurisdiction.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

Binding Unless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
(extensible to http://terminology.hl7.org/ValueSet/jurisdiction)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

112. Patient.extension:recordedSexOrGender.extension:comment

Slice Name comment

Definition

Further explanation about the context or source of the recorded sex or gender value

Short Context or source information about the recorded sex or gender

Control 0..1

Is Modifier false

Summary false

114. Patient.extension:recordedSexOrGender.extension:comment.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

116. Patient.extension:recordedSexOrGender.extension:comment.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

118. Patient.extension:recordedSexOrGender.extension:comment.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value comment

120. Patient.extension:recordedSexOrGender.extension:comment.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

122. Patient.extension:recordedSexOrGender.extension:genderElementQualifier

Slice Name genderElementQualifier

Definition

Short Whether this recorded sex or gender value qualifies the .gender element.

Control 0..1

Is Modifier false

Summary false

124. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

126. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

128. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value genderElementQualifier

130. Patient.extension:recordedSexOrGender.extension:genderElementQualifier.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

132. Patient.extension:recordedSexOrGender.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender

134. Patient.extension:recordedSexOrGender.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0
This element is affected by the following invariants: ext-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

136. Patient.extension:genderIdentity

Slice Name genderIdentity

Definition

Short Extension for representing how the person prefers to self-describe.

Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Control 0..*

Type Extension(Individual Gender Identity) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

138. Patient.extension:genderIdentity.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

140. Patient.extension:genderIdentity.extension

Definition

Short Additional content defined by implementations

Comments

Control 1..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

142. Patient.extension:genderIdentity.extension:value

Slice Name value

Definition

An individual's personal sense of being a man, woman, boy, girl, nonbinary, or something else.

Short The individual's gender identity

Comments

This represents an individual’s identity, ascertained by asking them what that identity is.

Control 1..1

Is Modifier false

Summary false

144. Patient.extension:genderIdentity.extension:value.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

146. Patient.extension:genderIdentity.extension:value.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

148. Patient.extension:genderIdentity.extension:value.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value value

150. Patient.extension:genderIdentity.extension:value.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

Binding Unless not suitable, these codes SHALL be taken from Gender Identity Value Set
(extensible to https://fhir.infoway-inforoute.ca/ValueSet/genderidentityvaluecode)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. Patient.extension:genderIdentity.extension:period

Slice Name period

Definition

The time period during which the gender identity applies to the individual

Short The time period during which the gender identity applies to the individual

Control 0..1

Is Modifier false

Summary false

154. Patient.extension:genderIdentity.extension:period.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

156. Patient.extension:genderIdentity.extension:period.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

158. Patient.extension:genderIdentity.extension:period.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value period

160. Patient.extension:genderIdentity.extension:period.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

162. Patient.extension:genderIdentity.extension:comment

Slice Name comment

Definition

Text to further explain the use of the specified gender identity

Short Text to further explain the use of the specified gender identity

Control 0..1

Is Modifier false

Summary false

164. Patient.extension:genderIdentity.extension:comment.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

166. Patient.extension:genderIdentity.extension:comment.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Patient.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

168. Patient.extension:genderIdentity.extension:comment.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value comment

170. Patient.extension:genderIdentity.extension:comment.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1
This element is affected by the following invariants: ext-1

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

172. Patient.extension:genderIdentity.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/StructureDefinition/individual-genderIdentity

174. Patient.extension:genderIdentity.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0
This element is affected by the following invariants: ext-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

176. Patient.extension:pronouns

Slice Name pronouns

Definition

Short Third-person pronouns that may reference a person's gender identity (e.g. he, she, they)

Comments

Control 0..*

Type Extension(Individual Pronouns) (Complex Extension)

Is Modifier false

Alternate Names extensions, user content

178. Patient.extension:birthsex

Slice Name birthsex

Definition

Short A code that specifies the sex of a person at birth which is a clinical finding

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

180. Patient.extension:CommunicationBarrier

Slice Name CommunicationBarrier

Definition

Optional Extension Element - found in all resources.

Short Optional Extensions Element

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

182. Patient.extension:locationId

Slice Name locationId

Definition

Reference to the location where the patient is registered or primarily receives care.

Short Reference to the location where the patient is registered

Control 1..1

Type Extension(Location ID) (Extension Type: string)

Is Modifier false

Summary false

184. Patient.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

Alternate Names extensions, user content

186. Patient.identifier

Definition

An identifier for this patient.

Short Patient identifiers including MedMe ID and optional JHN, PCID

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..*

Is Modifier false

Must Support true

Summary true

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
medme-pcid-system-check: If PCID system is present, type code must be PT (where(system = 'https://fhir.medmehealth.com/pharmacy-services/systems/entity/patient/pc-id').all(type.coding.where(system='http://terminology.hl7.org/CodeSystem/v2-0203' and code='PT').exists()))
medme-pcid-count: Maximum one PCID identifier allowed (where(system = 'https://fhir.medmehealth.com/pharmacy-services/systems/entity/patient/pc-id').count() <= 1)

This element introduces a set of slices on Patient.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:

pattern @ type

188. Patient.identifier:JHN

Slice Name JHN

Definition

Patient and person health numbers used by all jurisdictions across Canada

Short Jurisdictional Health Number

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

190. Patient.identifier:JHN.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

192. Patient.identifier:JHN.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

194. Patient.identifier:JHN.extension:versionCode

Slice Name versionCode

Definition

Optional Extension Element - found in all resources.

Short Health Number Version Code

Comments

Control 0..1
This element is affected by the following invariants: ele-1

Is Modifier false

Standard Status Normative (from Normative)

Summary false

Alternate Names extensions, user content

196. Patient.identifier:JHN.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. Patient.identifier:JHN.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 1..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Must Support true

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "JHN", "display" : "Jurisdictional Health Number" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

200. Patient.identifier:JHN.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short A Health Number Naming System from the Canadian URI Registry

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

202. Patient.identifier:JHN.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

204. Patient.identifier:JHN.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

206. Patient.identifier:JHN.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

208. Patient.identifier:MRN

Slice Name MRN

Definition

A local patient identifier from the submitting PoS System

Short Medical Record Number

Comments

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Is Modifier false

Summary true

Requirements

Patients are almost always assigned specific numerical identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

210. Patient.identifier:MRN.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

212. Patient.identifier:MRN.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

214. Patient.identifier:MRN.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

216. Patient.identifier:MRN.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 1..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Must Support true

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR", "display" : "Medical Record Number" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

218. Patient.identifier:MRN.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short An identifier for the system supplying the MRN

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

220. Patient.identifier:MRN.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

222. Patient.identifier:MRN.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

224. Patient.identifier:MRN.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

226. Patient.identifier:patientId

Slice Name patientId

Definition

An identifier for this patient.

Short MedMe patient identifier

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..1

Is Modifier false

Must Support true

Summary true

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
medme-identifier-required: At least one MedMe identifier is required (system.matches('https://fhir\.medmehealth\.com/pharmacy-services/systems/entity/(organization/[^/]+/)?patient/id'))

228. Patient.identifier:patientId.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

230. Patient.identifier:patientId.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

232. Patient.identifier:patientId.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

234. Patient.identifier:patientId.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MR" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

236. Patient.identifier:patientId.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

238. Patient.identifier:patientId.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

240. Patient.identifier:patientId.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

242. Patient.identifier:patientId.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

244. Patient.identifier:jhn

Slice Name jhn

Definition

An identifier for this patient.

Short Optional identifier representing Patient JHN (Quebec)

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Must Support true

Summary true

Requirements

Patients are generally assigned specific alphanumeric identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
jhn-extension-format: Must provide JHN version code if extension is used (extension.where(url = 'http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-identifierversion').all(valueString.exists() and valueString.length() > 0))

246. Patient.identifier:jhn.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

248. Patient.identifier:jhn.extension

Definition

An Extension

Short Extension

Control 0..1

Is Modifier false

Summary false

This element introduces a set of slices on Patient.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

250. Patient.identifier:jhn.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

252. Patient.identifier:jhn.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Pattern Value { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "JHN" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

254. Patient.identifier:jhn.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

256. Patient.identifier:jhn.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

258. Patient.identifier:jhn.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

260. Patient.identifier:jhn.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

262. Patient.active

Definition

It is often used to filter patient lists to exclude inactive patients

Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death.

Short Whether the patient is active

Comments

Control 1..1

Is Modifier true because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be able to mark a patient record as not to be used because it was created in error.

Meaning if Missing This resource is generally assumed to be active if no value is provided for the active element

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

264. Patient.name

Definition

A name associated with the individual.

Short Patient's name

Comments

A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns.

Control 1..*

HumanName

Is Modifier false

Must Support true

Summary true

Requirements

Need to be able to track the patient by multiple names. Examples are your official name and a partner name. The Alphabetic representation of the name SHALL be always provided

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ca-core-pat-1: Either Patient.name.given and/or Patient.name.family SHALL be present. ((family.exists() or given.exists()))

266. Patient.name.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

268. Patient.name.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

270. Patient.name.use

Definition

Identifies the purpose for this name.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from NameUse
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

The use of a human name.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

272. Patient.name.text

Definition

Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element

Short Text representation of the full name

Comments

Some systems will not have a field for representing the full name as a string, these systems are still expected to be able to demonstrate they can construct name.text when developing the patient summary instance

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

A renderable, unencoded form.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

274. Patient.name.family

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Short Family name

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names surname

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

276. Patient.name.given

Definition

Given name.

Short Given names

Comments

Control 1..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names first name, middle name

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

278. Patient.name.prefix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Short Parts that come before the name

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

280. Patient.name.suffix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Short Parts that come after the name

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

282. Patient.name.period

Definition

Indicates the period of time when this name was valid for the named person.

Short Time period when name was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows names to be placed in historical context.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

284. Patient.name.period.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

286. Patient.name.period.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.name.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

288. Patient.name.period.start

Definition

The start of the period. The boundary is inclusive.

Short Starting time with inclusive boundary

Comments

This attribute is considered 'Recommended - No Absent' in the current version of CACDI. No obligations have been applied at this time to recommended elements, however implementers are encouraged to support the element. Implementers that support this element should sent it if available and receivers should not produce failures or rejections if this element is provided (a base tenet of FHIR).

Control 0..1
This element is affected by the following invariants: per-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

290. Patient.name.period.end

Definition

Short End time with inclusive boundary, if not ongoing

Comments

Control 0..1
This element is affected by the following invariants: per-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Meaning if Missing If the end of the period is missing, it means that the period is ongoing

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

292. Patient.telecom

Definition

A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.

Short A contact detail for the individual

Comments

Control 0..*

ContactPoint

Is Modifier false

Must Support true

Summary true

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

294. Patient.telecom.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

296. Patient.telecom.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

298. Patient.telecom.system

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Short phone | fax | email | pager | url | sms | other

Control 1..1
This element is affected by the following invariants: cpt-2

Binding The codes SHALL be taken from ContactPointSystem
(required to http://hl7.org/fhir/ValueSet/contact-point-system)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

300. Patient.telecom.value

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Short The actual contact point details

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

302. Patient.telecom.use

Definition

Identifies the purpose for the contact point.

Short home | work | temp | old | mobile - purpose of this contact point

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

Binding The codes SHALL be taken from ContactPointUse
(required to http://hl7.org/fhir/ValueSet/contact-point-use)

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

304. Patient.telecom.rank

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Short Specify preferred order of use (1 = highest)

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Control 0..1

positiveInt

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

306. Patient.telecom.period

Definition

Time period when the contact point was/is in use.

Short Time period when the contact point was/is in use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

308. Patient.telecom.period.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

310. Patient.telecom.period.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.telecom.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

312. Patient.telecom.period.start

Definition

The start of the period. The boundary is inclusive.

Short Starting time with inclusive boundary

Comments

If the low element is missing, the meaning is that the low boundary is not known.

Control 0..1
This element is affected by the following invariants: per-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

314. Patient.telecom.period.end

Definition

Short End time with inclusive boundary, if not ongoing

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Control 0..1
This element is affected by the following invariants: per-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Meaning if Missing If the end of the period is missing, it means that the period is ongoing

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

316. Patient.gender

Definition

Short Administrative gender

Comments

Control 1..1

Binding The codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

Needed for identification of the individual, in combination with (at least) name and birth date.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

318. Patient.birthDate

Definition

The date of birth for the individual.

Short The date of birth for the individual

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

Control 0..1

date

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Age of the individual drives many clinical processes.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

320. Patient.birthDate.id

Definition

unique id for the element within a resource (for internal references)

Short xml:id (or equivalent in JSON)

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

322. Patient.birthDate.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.birthDate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

324. Patient.birthDate.extension:birthTime

Slice Name birthTime

Definition

The time of day that the Patient was born. This includes the date to ensure that the timezone information can be communicated effectively.

Short Time of day of birth

Comments

Control 0..1

Type Extension(Patient Birth Time) (Extension Type: dateTime)

Is Modifier false

Summary false

Alternate Names extensions, user content

326. Patient.birthDate.value

Definition

The actual value

Short Primitive value for date

Control 0..1

date

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

328. Patient.deceased[x]

Definition

Indicates if the individual is deceased or not.

Short Indicates if the individual is deceased or not

Comments

Control 0..1

Type Choice of: boolean, dateTime

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier true because This element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

330. Patient.address

Definition

Short Addresses for the individual

Comments

Control 0..*
This element is affected by the following invariants: ele-1

Type Address(Address(CA Core))

Is Modifier false

Must Support true

Summary true

Requirements

May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

332. Patient.address.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

334. Patient.address.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

336. Patient.address.use

Definition

The purpose of this address.

Short home | work | temp | old | billing - purpose of this address

Comments

Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from AddressUse
(required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

The use of an address.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows an appropriate address to be chosen from a list of many.

Example General: home

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

338. Patient.address.type

Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Short postal | physical | both

Comments

The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

Control 0..1

The codes SHALL be taken from AddressType
(required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

The type of an address (physical / postal).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General: both

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

340. Patient.address.text

Definition

Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

Short Text representation of the address

Comments

Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

A renderable, unencoded form.

Example General: 137 Nowhere Street, Erewhon 9132

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

342. Patient.address.line

Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Short Street name, number, direction & P.O. Box etc.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General: 137 Nowhere Street

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

344. Patient.address.city

Definition

The name of the city, town, suburb, village or other community or delivery center.

Short Name of city, town etc.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names Municpality

Example General: Erewhon

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

346. Patient.address.district

Definition

The name of the administrative area (county).

Short District name (aka county)

Comments

District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names County

Example General: Madison

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

348. Patient.address.state

Definition

Short Sub-unit of country (abbreviations ok)

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names Province, Territory

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

350. Patient.address.postalCode

Definition

A postal code designating a region defined by the postal service.

Short Postal code for area

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names Zip

Example General: 9132

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

352. Patient.address.country

Definition

Short Country (e.g. can be ISO 3166 2 or 3 letter code)

Comments

ISO 3166 3 letter codes can be used in place of a human readable country name.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

354. Patient.address.period

Definition

Time period when address was/is in use.

Short Time period when address was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows addresses to be placed in historical context.

Example General: { "start" : "2010-03-23", "end" : "2010-07-01" }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

356. Patient.maritalStatus

Definition

This field contains a patient's most recent marital (civil) status.

Short Marital (civil) status of a patient

Control 0..1

Unless not suitable, these codes SHALL be taken from Marital Status Codes
(extensible to http://hl7.org/fhir/ValueSet/marital-status)

The domestic partnership status of a person.

Is Modifier false

Summary false

Requirements

Most, if not all systems capture it.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

358. Patient.multipleBirth[x]

Definition

Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer).

Short Whether patient is part of a multiple birth

Comments

Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated).

Control 0..1

Type Choice of: boolean, integer

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

360. Patient.photo

Definition

Image of the patient.

Short Image of the patient

Comments

Guidelines:

Use id photos, not clinical photos.
Limit dimensions to thumbnail.
Keep byte count low to ease resource updates.

Control 0..*

Attachment

Is Modifier false

Summary false

Requirements

Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

362. Patient.contact

Definition

A contact party (e.g. guardian, partner, friend) for the patient.

Short A contact party (e.g. guardian, partner, friend) for the patient

Comments

Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.

Control 0..*

Is Modifier false

Summary false

Requirements

Need to track people you can contact about the patient.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
pat-1: SHALL at least contain a contact's details or a reference to an organization (name.exists() or telecom.exists() or address.exists() or organization.exists())

364. Patient.contact.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

366. Patient.contact.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

368. Patient.contact.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

370. Patient.contact.relationship

Definition

The nature of the relationship between the patient and the contact person.

Short The kind of relationship

Control 0..*

Unless not suitable, these codes SHALL be taken from PatientContactRelationship
(extensible to http://hl7.org/fhir/ValueSet/patient-contactrelationship)

The nature of the relationship between a patient and a contact person for that patient.

Is Modifier false

Summary false

Requirements

Used to determine which contact person is the most relevant to approach, depending on circumstances.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

372. Patient.contact.relationship.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

374. Patient.contact.relationship.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.contact.relationship.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

376. Patient.contact.relationship.coding

Definition

A reference to a code defined by a terminology system.

Short Code defined by a terminology system

Comments

Control 1..1

Is Modifier false

Summary true

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

378. Patient.contact.relationship.coding.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

380. Patient.contact.relationship.coding.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.contact.relationship.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

382. Patient.contact.relationship.coding.system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Short Identity of the terminology system

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Fixed Value http://hl7.org/fhir/ValueSet/patient-contactrelationship

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

384. Patient.contact.relationship.coding.version

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Short Version of the system - if relevant

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Note This is a business version Id, not a resource version Id (see discussion)

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

386. Patient.contact.relationship.coding.code

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Short Symbol in syntax defined by the system

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to refer to a particular code in the system.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

388. Patient.contact.relationship.coding.display

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Short Representation defined by the system

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

390. Patient.contact.relationship.coding.userSelected

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Short If this coding was chosen directly by the user

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

392. Patient.contact.relationship.text

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Short Plain text representation of the concept

Comments

Very often the text is the same as a displayName of one of the codings.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

394. Patient.contact.name

Definition

A name associated with the contact person.

Short A name associated with the contact person

Control 0..1

HumanName

Is Modifier false

Summary false

Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

396. Patient.contact.name.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

398. Patient.contact.name.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.contact.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

400. Patient.contact.name.use

Definition

Identifies the purpose for this name.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from NameUse
(required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

The use of a human name.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

402. Patient.contact.name.text

Definition

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

Short Text representation of the full name

Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

A renderable, unencoded form.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

404. Patient.contact.name.family

Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Short Family name

Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names surname

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

406. Patient.contact.name.given

Definition

Given name.

Short Given names

Comments

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Alternate Names first name, middle name

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

408. Patient.contact.name.prefix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Short Parts that come before the name

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

410. Patient.contact.name.suffix

Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Short Parts that come after the name

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

412. Patient.contact.name.period

Definition

Indicates the period of time when this name was valid for the named person.

Short Time period when name was/is in use

Control 0..1

Is Modifier false

Summary true

Requirements

Allows names to be placed in historical context.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

414. Patient.contact.telecom

Definition

A contact detail for the person, e.g. a telephone number or an email address.

Short Contact details

Comments

Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Control 0..*

ContactPoint

Is Modifier false

Summary false

Requirements

People have (primary) ways to contact them in some way such as phone, email.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

416. Patient.contact.telecom.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

418. Patient.contact.telecom.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.contact.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

420. Patient.contact.telecom.system

Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Short phone | fax | email | pager | url | sms | other

Control 1..1
This element is affected by the following invariants: cpt-2

Binding The codes SHALL be taken from ContactPointSystem
(required to http://hl7.org/fhir/ValueSet/contact-point-system)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

422. Patient.contact.telecom.value

Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Short The actual contact point details

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

424. Patient.contact.telecom.use

Definition

Identifies the purpose for the contact point.

Short home | work | temp | old | mobile - purpose of this contact point

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Control 0..1

The codes SHALL be taken from ContactPointUse
(required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

Use of contact point.

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

426. Patient.contact.telecom.rank

Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Short Specify preferred order of use (1 = highest)

Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Control 0..1

positiveInt

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

428. Patient.contact.telecom.period

Definition

Time period when the contact point was/is in use.

Short Time period when the contact point was/is in use

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

430. Patient.contact.address

Definition

Address for the contact person.

Short Address for the contact person

Control 0..1

Address

Is Modifier false

Summary false

Requirements

Need to keep track where the contact person can be contacted per postal mail or visited.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

432. Patient.contact.gender

Definition

Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes.

Short male | female | other | unknown

Control 0..1

The codes SHALL be taken from AdministrativeGender
(required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

The gender of a person used for administrative purposes.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

Needed to address the person correctly.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

434. Patient.contact.organization

Definition

Organization on behalf of which the contact is acting or for which the contact is working.

Short Organization that is associated with the contact

Control 0..1
This element is affected by the following invariants: pat-1

Type Reference(Organization)

Is Modifier false

Summary false

Requirements

For guardians or business related contacts, the organization is relevant.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

436. Patient.contact.period

Definition

The period during which this contact person or organization is valid to be contacted relating to this patient.

Short The period during which this contact person or organization is valid to be contacted relating to this patient

Control 0..1

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

438. Patient.communication

Definition

A language which may be used to communicate with the patient about his or her health.

Short Languages which may be used to communicate with the patient

Comments

This element is included in the CACDI. In future versions additional constraints or obligations may be applied to this element.

Control 0..*

Is Modifier false

Summary false

Requirements

If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

440. Patient.communication.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

442. Patient.communication.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

444. Patient.communication.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

446. Patient.communication.language

Definition

Short The language which can be used to communicate with the patient about his or her health

Comments

Control 1..1

The codes SHOULD be taken from http://terminology.hl7.org/NamingSystem/iso639-3
(preferred to http://terminology.hl7.org/NamingSystem/iso639-3)

A human language.

Additional Bindings

Purpose

Is Modifier false

Summary false

Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

448. Patient.communication.language.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

450. Patient.communication.language.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.communication.language.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

452. Patient.communication.language.coding

Definition

A reference to a code defined by a terminology system.

Short Code defined by a terminology system

Comments

Control 1..1

Is Modifier false

Summary true

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

454. Patient.communication.language.coding.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

456. Patient.communication.language.coding.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Patient.communication.language.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

458. Patient.communication.language.coding.system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Short Identity of the terminology system

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Fixed Value http://terminology.hl7.org/CodeSystem/language

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

460. Patient.communication.language.coding.version

Definition

Short Version of the system - if relevant

Comments

Note This is a business version Id, not a resource version Id (see discussion)

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

462. Patient.communication.language.coding.code

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Short Symbol in syntax defined by the system

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to refer to a particular code in the system.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

464. Patient.communication.language.coding.display

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Short Representation defined by the system

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

466. Patient.communication.language.coding.userSelected

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Short If this coding was chosen directly by the user

Comments

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

468. Patient.communication.language.text

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Short Plain text representation of the concept

Comments

Very often the text is the same as a displayName of one of the codings.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

470. Patient.communication.preferred

Definition

Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).

Short Language preference indicator

Comments

This language is specifically identified for communicating healthcare information.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

472. Patient.generalPractitioner

Definition

Patient's nominated care provider.

Short Patient's nominated primary care provider

Comments

Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type.

Control 0..*

Type Reference(Practitioner (CA-Core), PractitionerRole (CA-Core), Organization (CA-Core))

Is Modifier false

Must Support true

Must Support Types No must-support rules about the choice of types/profiles

Summary false

Alternate Names careProvider

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

474. Patient.managingOrganization

Definition

Organization that is the custodian of the patient record.

Short Organization that manages the care of this patient

Comments

Control 1..1

Type Reference(MedMe Pharmacy Organization)

Is Modifier false

Summary true

Requirements

Need to know who recognizes this patient record, manages and updates it.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

476. Patient.link

Definition

Link to another patient resource that concerns the same actual patient.

Short Link to another patient resource that concerns the same actual person

Comments

There is no assumption that linked patient records have mutual links.

Control 0..*

Summary true

Requirements

There are multiple use cases:

Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and
Distribution of patient information across multiple servers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

478. Patient.link.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

480. Patient.link.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

482. Patient.link.modifierExtension

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

484. Patient.link.other

Definition

The other patient resource that the link refers to.

Short The other patient or related person resource that the link refers to

Comments

Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.

Control 1..1

Type Reference(Patient, RelatedPerson)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

486. Patient.link.type

Definition

The type of link between this patient resource and another patient resource.

Short replaced-by | replaces | refer | seealso

Control 1..1

The codes SHALL be taken from LinkType
(required to http://hl7.org/fhir/ValueSet/link-type|4.0.1)

The type of link between this patient resource and another patient resource.